Mr BAYLEY - Before I start, I add my voice to the acknowledgement of victims/survivors, whistleblowers, advocates and others who so bravely stood up and got us to the place where we are here today, which is scrutinising some very important Government decisions. I acknowledge the work of those people and stand in solidarity and offer my strength to them.
Just quickly, on those three people who are named, how many are still working in the Health department?
Ms MORGAN-WICKS - The three people who are named in findings in the final report are no longer working in the Department of Health.
Mr BAYLEY - None of them is working in the department. Thank you.
Recommendation 12.21 would appear to be a very logical step, given the demonstrable health impacts inside youth detention - a recommendation that would, at face value, be very simple to implement. I am perplexed as to why it wouldn't have long been standard practice. I will read it out:
That the Tasmanian Government should ensure children and young people in detention (including on remand): receive a mental and physical health assessment on admission to the detention facility, and when needed while in detention...
Understandably, the commission delivered this in a very short term window to be delivered before July 2024. But the Government's response indicates that implementation will be subject to an expanded existing in reach health model designed to accommodate the now Southern Detention Centre, which is still many years away, and the two assisted bail facilities. And it won't start until 2024 and be completed by 2026. I find the explanation of this in the response relatively shallow and bureaucratic, and I think it leaves children in Ashley at risk. If the existing model is to be expanded, how will it be changed to include assessments on admission? And why is there is the resistance to implementing this up front?
Mr BARNETT - Thank you for the question. There is definitely a strong element of that relating to mental health and wellbeing for the young Tasmanians to which the member refers. I have the secretary on my right but the deputy secretary covers the mental health and wellbeing aspects. I would like to see if the deputy secretary could respond to that question.
Mr WEBSTER - As answered by the Premier in a previous session, we are growing this service over time. It will grow to match the additional buildings that occur across youth justice. It isn't a case of we are waiting for the buildings but we will recruit to grow to that service. Recruitment is under way. The reason we are saying it starts in 2024 is recruiting, particularly for the mid north to Deloraine, has proved difficult. But we do actually provide 10 hours a day a nurse on site who does assessments. That is supported by 24/7 on call to our Correctional Primary Health Service. There is actually a 24/7 service available. We need to grow that and we've got plans for additional staff being employed over the period - then the resources matching to the buildings when we've got multiple facilities. That's why it looks like it's a long-term goal but we'll start straight away, then match as we build.
Mr BAYLEY - I understand that but is there a reason why there is no assessment done on admission? I assume the recommendation from the commission is simply so that you can have a base-level assessment of that child or young person as they enter your facility and you know then how to treat them. Are you telling me that children still go into that facility today, if they are admitted, and don't have that assessment up front to inform their care going forward?
Mr WEBSTER - No, they have an assessment now.
Mr BAYLEY - A mental health and a health assessment?
Mr WEBSTER - A physical and a mental health assessment. What we're growing is the additional resources because there are a number of recommendations in this space, one of which is that we have a psychiatrist on deck once a fortnight and psychologist resources. As we explained earlier to the hearing, we have advertised those. We're hopeful of having the psychiatrist relatively soon, as early as February next year. The psychologist roles have been advertised, or are about to be advertised, I think he said this morning. So, we are moving forward with the recommendation to grow resources to make sure we are implementing all of the suite of recommendations around mental health support for people in detention.
Mr BAYLEY - What are the assessments they get today if they were to go into the detention facility? You would read the commission of inquiry report and their recommendation that these children receive a mental and physical health assessment on admission as meaning that they don't at the moment. So, what is changing? Did the commission get it wrong?
Mr WEBSTER - The commission had evidence before it but what we do: on admission a nurse takes them through a number of assessments - everything from their physical health, suicidal ideation is looked at as well because we need that information up front, as well as an assessment of mental health. We want to improve the mental health side of that by employing specific mental health staff such as the psychiatrist and the psychologist.
Mr BAYLEY - And it's simply a recruitment issue that means you can no longer deliver it in the 1 July 2024 time frame?
Mr WEBSTER - We will deliver the first element of it by July 2024 if we can recruit, and we're pretty confident of that, given what I have just said about us having one under way. But we won’t complete it because the recommendation is that we provide that to all the facilities, and the facilities aren't there yet. We didn't want to say we've completed this by July 2024 when, in fact, we won't have the facilities to deliver it in. It aligns with other recommendations.
Ms MORGAN-WICKS - As Mr Webster has just mentioned, we need to then align that physical recruitment with the location of the services as they are going to change over time, which can often be tricky in a health environment. What we do to try to get around that is to recruit on a statewide basis and set expectations as to the amount of travel, or the location of services that a particular clinician is required to provide.
Mr BAYLEY - I still find it curious because the recommendation is blind around the future models of care and detention. It's just talking about, as of today, children and young people in detention should receive these health assessments on admission. I accept what you're telling me but, in black and white, in terms of the commission report and, indeed, the Government's response, they don't fully add up. I think there should be stronger emphasis on ensuring that everything is covered as at today in terms of those children and young people when they're admitted.
Ms MORGAN-WICKS - I would also say that Correctional Primary Health has significant experience, not just in the assessment of youth detention but also adult detention. That is something that we provide on a daily, if not hourly, basis, particularly, for example, at Risdon Prison. We have significant resources that are already contained within Correctional Primary Health. We note that the commission has made that recommendation. The commission has many other recommendations, for example, in relation to health culture, where we had provided evidence to the commission about the steps that we were taking to improve the culture within Health. We can't comment on how that has reached that formal conclusion. We're very happy to be reminded that it's a requirement. It's absolutely significant in the commission's view that we get that right, so we accept that.
Mr BAYLEY - I accept that you have those steps in place and that evidence was presented to the commission. I would contend that if the commission nonetheless issued a written explicit response asking for some level of change, they didn't necessarily have confidence in the procedures and the practice as it stands today and they wanted to see some change into the future.
Mr WEBSTER - We fully accept that, which is why we are growing our workforce to make sure that we are delivering that absolute top notch. Professor McDermott, who is our statewide clinical director of CAMHS (Child and Adolescent Mental Health Services), was at the table earlier and explained the need to recruit and the need to develop a model of care that fits not just admission to youth detention, but admission to youth justice.
